• Pat Rohan, Conor Casey, Gregory J Nason, Jan Sorensen, and Kenneth Mealy.
• Department of Surgery, Wexford General Hospital, Wexford, Ireland. Pat.rohan@ucdconnect.ie.
• Ir J Med Sci. 2022 Feb 1; 191 (1): 113-117.

BackgroundUrolithiasis is a common urological presentation1. A total of 25-49 million people in Europe live with symptomatic stone disease, with the incidence increasing1.AimsTo examine length of stay (LOS) and transfer patterns for patients presenting with urolithiasis to Irish Model 2/3 hospitals without a specialist urology service, compared with those who present to a model 4 hospital with an on-site urology service.MethodsUsing the National Quality Assurance & Improvement System (NQAIS), we assessed patients presenting with urolithiasis, nationally from January 2016 to December 2019.ResultsDuring the study period, there were 11,856 emergency presentations with urolithiasis. A total of 6510 (54.9%) presented to model 4 hospitals, while 5346 (45.1%) presented to model 2/3 hospitals. A total of 874 (16.35%) patients required transfer from model 2/3 hospital to a model 4 hospital for further management. Those transferred from model 2/3 hospitals spent a mean of 3.68 days awaiting transfer and had a mean LOS of 3.88 days in the model 4 hospital. A total of 7.56 days compared with a mean LOS of 2.9 days for those presenting directly to a model 4 hospital.ConclusionAt a national level in Ireland, many patients with urolithiasis present to hospitals that are unable to cater for their needs. Patients presenting with urolithiasis to model 2/3 hospitals have significantly longer LOS compared with patients who present directly to a model 4 hospital. A formal 'stone pathway' is required to provide timely care for these patients2-such a pathway would provide better patient care and result in improved bed utilisation.© 2021. Royal Academy of Medicine in Ireland.

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